Cholesterol

Your blood vessels and heart are called your cardiovascular system. One of the best ways to prevent cardiovascular disease (such as stroke, heart attack and angina) is to keep your cholesterol at a healthy level.

Cholesterol, what is it?

Your blood vessels and heart are called your cardiovascular system. One of the best ways to prevent cardiovascular disease (such as stroke, heart attack and angina) is to keep your cholesterol at a healthy level.

Cholesterol is a type of fat found in your blood. You need a certain amount to produce hormones. But too much cholesterol sticks to your artery walls to form plaque. This plaque can build up and may block or narrow the artery. This process is called atherosclerosis.

If an artery becomes blocked, the heart muscle becomes damaged, this is known as a heart attack. If an artery to the brain is blocked, it may damage the brain, and this is called a stroke.

Why is a healthy cholesterol important?

The main cause of cardiovascular disease is the hardening of arteries through plaque known as atherosclerosis. High cholesterol increases your chances of cardiovascular disease such as heart attack and stroke.

Having high cholesterol affects people of all ages. Making small changes now can make a big difference to your life now and in the future, especially if you already have heart disease or a family history of it.

First, where does cholesterol come from?

Cholesterol is made in the body mainly by the liver. This is often called blood cholesterol. The body can produce all the cholesterol it needs to carry out its many functions and can usually maintain a healthy level of blood cholesterol.

However, sometimes the balance goes wrong and there is an increase in blood cholesterol. This may result from inherited problems or from eating too much saturated (animal) fat or too many foods from the top shelf of the pyramid

There are two main types of cholesterol:

HDL cholesterol (High Density Lipoprotein): this is called good cholesterol or healthy cholesterol. Why? Because HDL cholesterol mops up cholesterol left behind in your arteries and carries it to your liver where it is broken down and passed out of your body. Regular physical activity and exercise can help increase your HDL level. High levels of HDL cholesterol can protect you against having a heart attack or a stroke.

LDL cholesterol (Low Density Lipoprotein): this travels from your liver through your arteries to other parts of your body. LDL is called bad cholesterol because it sticks to the walls in your arteries – making them narrow. This reduces the blood supply to your heart or brain. Eating too many foods high in saturated fat can raise your LDL cholesterol. High levels of LDL cholesterol increase your risk of heart disease and stroke.

As a memory aid, think of the ‘H’ in High Density Lipoprotein (HDL) as ‘Healthy’ cholesterol, whereas think of the ‘L’ in Low Density Lipoprotein as ‘Lousy’ cholesterol.

And then there’s triglycerides:

Triglycerides are another type of fat found in your blood. Too much triglyceride in your blood can increase your chances of getting heart disease and stroke.

Could I have high (or too much) triglycerides? Yes, anyone can have high levels, but it is more likely if you are: overweight; drink too much alcohol; eat lots of sugary foods; or are not very active. Ask your doctor to check your triglyceride levels.

How can I keep my cholesterol healthy?

The level of cholesterol in your blood is affected by the amount of saturated fats you eat every day.

Some foods such as eggs, liver and shellfish contain cholesterol. However, the amount of cholesterol in these foods does not greatly affect the amount of cholesterol in your blood. You can eat foods that contain cholesterol in moderation as part of a varied healthy diet.

If you do not have a high blood cholesterol level, you can eat up to 7 eggs a week. However, if you have been diagnosed with a high cholesterol level, you may be advised to eat less eggs, depending on your diet.

A few simple food changes:

Eat fish twice a week including oily fish such as sardines and salmon

Cut down the sweets, biscuits, sugary drinks, jams and cakes etc.

Use healthy ways of cooking like grilling and oven baking instead of frying

There are now a range of foods, from spreads to milk, that have ingredients that help to stop your body absorbing cholesterol. Please note: Cholesterol-lowering foods are not a replacement for cholesterol-lowering medicine. Always talk to your doctor for more information.

How do fats in foods affect cholesterol?

There’s a mix of fats in foods. There are saturated fats, unsaturated fats (e.g. monounsaturated fats and polyunsaturated fats) and trans fats. It’s important to know your fats, the good ones and the bad ones – and their effects.

The Good Fats

Monounsaturated fats (help lower your bad cholesterol)

Monounsaturated fats are found in many foods but the main sources include olive, peanut and rapeseed (canola) oil, spreads that contain these oils, as well as avocados, seeds and some nuts (for example cashews, almonds and peanuts).

What are their effects? Monounsaturated fats can help lower the amount of LDL (bad) cholesterol in your blood and reduce your chances of heart disease and stroke. As a memory aid, think of the ‘o’s in mono as good.

Polyunsaturated fats (Omega 3 and 6 help lower your bad cholesterol)

There are two main types of polyunsaturated fats: omega 3 fats and omega 6 fats. These fats are sometimes called essential fats because our bodies cannot make them and we have to get them from the food we eat.

Omega 3 fats are found in oily fish such as salmon, mackerel, trout, herring and sardines. Tuna is also an oily fish. However, if you’re using tinned tuna, make sure the label says that omega 3 fats have been replaced, as these healthy fats are normally lost during the tinning process.

What are their effects? Omega 3 fats can help your heart to keep a healthy rhythm and prevent blood clots. They can also help to lower another type of fat in the blood called triglycerides.

Omega 6 fats are found mainly in vegetable oils such as sunflower, safflower, corn, soya bean and sesame oils. Soya beans and some nuts, for example walnuts, hazelnuts and brazil nuts, also contain Omega 6 fats.

What are their effects? Omega 6 fats can help to lower LDL (bad) cholesterol and reduce your chances of heart disease and stroke.

The Bad Fats

Saturated fats (raise your bad cholesterol)

Saturated fats are found in foods like butter, hard margarine, lard, cream, cheese, fatty meat, cakes, biscuits and chocolates. Vegetable oils such as coconut oil and palm oil are also high in saturated fat. Check the food labels on processed and ready-made meals for the amount of saturated fats.

What are their effects? Saturated fats can raise your LDL (bad) cholesterol and increase your chances of heart disease or having a stroke.

Trans Fats (e.g. ‘hydrogenated’ raises cholesterol)

Trans fats are mainly found in processed foods such as cakes, biscuits, pastries and deep-fried foods. If a food’s list of ingredients contains the words ‘hydrogenated oils’ or ‘hydrogenated fat’, it is likely to contain trans fats.

What are their effects? Trans fats lower your HDL (good) cholesterol and raise the level of LDL (bad) cholesterol in the blood. As a memory aid, say No to Hydro-genated fats.

And have a regular blood pressure and cholesterol check with your doctor

Getting your cholesterol checked

Your cholesterol can be measured by your doctor, who knows your family history. If a family member has high cholesterol, heart disease or has had a stroke, it’s really important you ask your doctor to do a cholesterol test. You can ask for this on any visit.

If your results show a blood cholesterol level greater than five mmol/l, or if your doctor is concerned about your HDL (good) or LDL (bad) cholesterol, they will arrange for another test. You will need to fast for 12 hours to get more information on your HDL and LDL cholesterol.

As well as HDL and LDL levels, the more detailed test will show triglyceride levels – another type of fat. Anyone can have high levels of triglyceride, but it is more likely if you are: overweight; drink too much alcohol; eat lots of sugary foods; or are not very active.

The numbers to watch out for

If you have previously had a heart attack, bypass surgery or angioplasty, it’s also very important that you keep your LDL at or below 2.5 mmol/l. Your doctor will most likely suggest medication together with healthy eating and other lifestyle changes.

Cholesterol And Triglycerides Healthy levels:

Total cholesterol:

No more than 5 mmol/l

LDL cholesterol:

No more than 3 mmol/l

HDL cholesterol:

More than 1 mmol/l

Triglycerides:

No more than 2 mmol/l

For people with heart disease or diabetes

Total cholesterol:

No more than 4.5 mmol/l

LDL cholesterol:

No more than 1.8 mmol/l

If you need to change any aspects of your cholesterol or triglyceride levels, your doctor will advise you on changes in lifestyle and may recommend medication. If you are prescribed medication, please make sure you follow the instructions carefully.